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Ohioans’ health hangs in the balance

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Saturday June 8, 2013 4:51 AM

There’s a battle at the Statehouse between lawmakers in favor of expanding Medicaid and those
who oppose it. In the middle are 275,000 Ohioans who wonder if, come January, they’ll be able to go
get a physical exam or a mammogram.

Most of the people who stand to benefit from Medicaid expansion are the working poor. They work
hard every day but don’t receive health coverage from their employers.

A goal of the federal health-reform law was to provide health coverage to most Americans by
expanding Medicaid or through state health-insurance exchanges. The federal government has pledged
to pick up at least 90 percent of the cost of the expansion for the next seven years, including 100
percent the first three years.

The law assumed states would expand Medicaid, but the U.S. Supreme Court ruled that states could
decide whether to expand. Gov. John Kasich included the expansion in his biennial budget, but it
was removed from the bill by the Ohio House of Representatives.

I’m disappointed that lawmakers removed the expansion, but as a physician and health-care
leader, I’m encouraged by the bill Rep. Barbara Sears, a Republican from suburban Toledo,
introduced to keep it alive.

Health-care access hangs in the balance for these 275,000 Ohioans. Most are childless adults
whose individual annual earnings are less than $11,490. They don’t qualify for existing Medicaid
and don’t earn enough to receive tax credits through the state exchange.

These Ohioans are the people we see every day in hospital emergency rooms across Ohio. Many have
health conditions that can be easily and affordably managed by a doctor or nurse practitioner. But
they lack coverage to give them access to primary-care and preventive health services. A recent
Ohio State University study confirmed that Ohioans with Medicaid had far better health outcomes
than the uninsured.

Manageable conditions such as high blood pressure and high cholesterol that go untreated can
escalate to a stroke requiring hospitalization and rehabilitation. And, as the recent
Dispatch series “Mental Hell” (May 26-28) showed, people with mental illnesses are at most
risk of not getting the services they need if Medicaid isn’t expanded.

Yes, hospitals would benefit from expansion because we’d receive payment for services that
currently are unpaid. But consumers and employers also would benefit. The cost of caring for the
uninsured is assumed by hospitals, businesses and workers through higher insurance premiums.

Taking advantage of the federal funding available to expand Medicaid is the responsible thing to
do. It would help improve the health and well-being of 275,000 Ohioans and the financial state of
Ohio.

A nonpartisan study released earlier this year found that Ohio’s net gain from the expansion
would be $104 million in 2014 and $1.4 billion by 2022. The expansion will pay for itself from 2020
on when the state’s obligation is at 10 percent.

Expanding Medicaid under federal health reform does not mean the program cannot be made more
efficient and effective. The Governor’s Office of Health Transformation has already made positive
changes to Medicaid that will continue into the future.

Ohio is standing at the door of opportunity. Let’s not squander this chance to truly improve the
lives of 275,000 of our fellow residents and enhance the economic condition of our state.